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患者22岁,29天前在某医院因早孕行人工流产术.术前医生内诊检查诊断为“双子宫”,术中情况不详.术后第3天出现下腹部隐痛,对症治疗无好转,近日加重来院.检查:患者表情淡漠,强迫左侧卧位.口唇及睑结膜苍白.Bp9/5kPa.腹稍胀,压痛及反跳痛明显,肠鸣音消失,移动浊音(+).检 Hb40g/L.内诊宫颈举痛明显,后穹窿不饱满,宫体水平偏右,左附件增厚,压痛明显.腹穿抽出2ml 陈旧血.立即行剖腹探查术,术中清除腹盆腔内积血块及积血1300ml,探查发现患者为双角子宫,两宫体之间有一扇形韧带相连,子宫峡部融合为一个宫颈,右侧宫体正常大小,左侧宫体超鸭卵大,底部有3×25cm 的裂口,可见活动性出血.行子宫修补术.术后病人恢复良好.本例人流术中吸头或刮匙致子宫穿孔,由于血栓
Patients 22 years, 29 days ago in a hospital due to early pregnancy abortion .Physiological examination of preoperative diagnosis of “double uterus”, the intraoperative situation is unknown .Postoperative 3 days of lower abdominal pain, symptomatic treatment without improvement, Recently aggravating to the hospital.Check: the patient’s expression indifferent, forced the left lateral position.Lips and conjunctiva pale.Bp9 / 5kPa.Abdominal distension, tenderness and rebound pain obvious, bowel sounds disappear, shifting dullness (+). Hb40g / L. Internal cervical pain was obvious, after the dome is not full, the body of the right side of the body, the left attachment thickening, tenderness significantly. Abdominal wear out 2ml old blood. Immediate laparotomy exploration, intraoperative ablation of the pelvic mass And hemorrhage 1300ml, exploration found that patients with double angle uterus, between the two bodies of a ligament shaped ligament, the isthmus is a cervical fusion, the normal size of the right side of the palace, the left side of the palace over duck eggs, the bottom of 3 × 25cm of the gap, showing active bleeding .Humanic uterine repair.After the patient recovered well.This case of abortion or curettage caused by uterine perforation, due to thrombus